Healthcare Provider Details

I. General information

NPI: 1184200339
Provider Name (Legal Business Name): HEALTHRUS URGENT CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2021
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13622 BEAR VALLEY RD STE 9
VICTORVILLE CA
92392-8509
US

IV. Provider business mailing address

13622 BEAR VALLEY RD UNIT 9 & 10
VICTORVILLE CA
92392-8509
US

V. Phone/Fax

Practice location:
  • Phone: 909-908-0371
  • Fax: 442-327-9507
Mailing address:
  • Phone: 909-908-0371
  • Fax: 442-327-9507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN OPARA
Title or Position: ADMINISTRATOR
Credential:
Phone: 909-908-0371